Avram Victoria, Petruccelli Danielle, Winemaker Mitch, de Beer Justin
Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
J Arthroplasty. 2014 Mar;29(3):465-8. doi: 10.1016/j.arth.2013.07.039. Epub 2013 Aug 28.
Given institutional pressures to reduce hospital length of stay (LOS) we hypothesized that "failure to cope" would be a significant factor for readmission following total joint arthroplasty (TJA). A retrospective review of 4288 TJA patients was conducted to determine readmission rates and reasons for readmit within 30 days of discharge. Ninety-five patients (2.2%; 95% CI: 1.8%-2.7%) were readmitted. Leading diagnoses were surgical site infection (23.2%) and cardiovascular event (16.8%). Of readmits 5.3% (5/95) were readmitted for failure to cope, representing 0.1% of the sample. In multivariate analysis, increased age was a significant predictor of readmission (OR = 0.974, 95% CI 0.952-0.997). Contrary to our hypothesis failure to cope was not a leading diagnosis for readmission; concerns remain that early discharge may however correlate with increased readmit rates.
鉴于存在缩短住院时间(LOS)的制度压力,我们推测“应对失败”将是全关节置换术(TJA)后再入院的一个重要因素。我们对4288例TJA患者进行了回顾性研究,以确定出院后30天内的再入院率及再入院原因。95例患者(2.2%;95%置信区间:1.8%-2.7%)再次入院。主要诊断为手术部位感染(23.2%)和心血管事件(16.8%)。在再入院患者中,5.3%(5/95)因应对失败而再次入院,占样本的0.1%。多因素分析显示,年龄增加是再入院的一个重要预测因素(比值比=0.974,95%置信区间0.952-0.997)。与我们的假设相反,应对失败并非再入院的主要诊断;不过,人们仍然担心早期出院可能与再入院率增加有关。